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CARDIOVASCULAR & RENAL SYS Etiology of Heart failure Positive Inotropic Agents,

Positive Inotropic Agents treats ______ failure. Congestive heart failure
What is heart failure? Heart failure is a cluster of signs & symptoms that occur when the L, R, or both ventricles lose the ability to pump enough blood to meet the body’s circulatory needs.

What is heart failure treated with? Combination of: 1. vasodilator, 2. inotropic, 3. diuretic therapy
Vasodilators reduce___ so that the high volume of blood returning to the heart is _____ .This decreases pulmonary ____ & allows the patient to breathe. preload;decreased; congestion;
Positive Inotropic agents stimulate the heart to _____the force of contractions, thus boosting ______. They also help reduce pulmonary congestion & improve _____ perfusion. increase ; cardiac output; tissue
Negative inotropic agents____the force of contraction (beta blockers, calcium channel blockers). decrease
Diuretics help____ blood volume & water retention; they reduce the _____and central venous pressures, which are the filling pressures of the ventricles. decrease; preload ;
Inotropic drugs influence the ____of muscular_____ force ; contractions
Chronotropic drugs influence the _____of the heartbeat rate
Dromotropic drugs influence the ______ of _____impulses conduction ;electrical
Ejection Fraction reflects heart _____ contractility
What are two Positive inotropic drug classes? 1. Cardiac glycosides 2. Phosphodiesterase inhibitors

Lanoxin (digoxin) is a ____ Cardiac Glycosides
Lanoxin (digoxin) ____force of contraction (pos. inotropy) Increases
Lanoxin (digoxin) ____the HR (neg. chronotropy) Slows
Lanoxin (digoxin) _____ electrical conduction in heart (neg. dromotropy) Reduces
What are the side effects of Lanoxin ( digoxin)? 1. N/V, 2. Restlessness/Irritability, 3. Confusion, 4. Disorientation, 5. Blurred vision, 6. Halos around objects, 7. Dysrhythmias (toxicity)
Therapeutic drug level of Digoxin = _____ to____ ng/mL 0.5 – 2.0
S/S Digoxin toxicity: is induced ____hyperkalemia (level >5 mEq/L), ventricular ______ or fibrillation arrhythmias, tachycardia
When does hypokalemia occur? Hypokalemia occurs when patient has anorexia, nausea, vomiting, diarrhea or heavy diuresis; predisposes pt. to digitalis toxicity.
Antidoate for digoxin toxicity is___ Digoxin Immune FAB (Digibind)
What are the drug interactions of Digoxin are Potassium sparing diuretics & Beta-Adrenergic Blockers
Nursing Considerations for digoxin are ? 1. Check HR 60 bpm - 120 bpm Note: IF Less than 60 or greater than 120, DO NOT GIVE MEDICATION
You must take ____ pulse for one full minute when digoxin is administered apical
When administering digoxin you should monitor: 1. Monitor Digoxin level 2. Monitor serum potassium level
Bran in large amounts may ____absorption of _____ drugs (do not take oral digoxin at same time as eating bran fiber) decrease ; oral digitalis
Phosphodiesterase Inhibitors _____ the ____ & velocity of myocardial contractions Increase; force
Phosphodiesterase Inhibitors Relax _____muscle to cause _____, reducing preload & afterload vascular smooth/ vasodilation,
Phosphodiesterase Inhibitors are used for ____-term management of systolic dysfunction heart failure in patients who have not responded to digitalis, diuretics, or vasodilator therapy short
What are two examples of Phosphdiesterase? 1. Inocor (inamrinone) 2. Primacor (milrinone)
What are the three adverse effects of Phosphodiesterase Inhibitors? Thrombocytopenia (inamrinone) Dysrhythmias (milrinone) Hypotension secondary to vasodilation (both)
What are the 5 cardiac properties? Conductivity, Automaticity, Irritablity, Contractility, Excitability
Created by: jwhite223



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